NURS 231/NURS231 Module 6 V2 |
Pathophysiology Q&A with Rationale | Portage
Learning
1. A patient presents with excessive thirst (polydipsia), a high serum sodium level, and a very
low urine specific gravity. Which of the following conditions is most likely responsible for
these findings?
A. SIADH
B. Cushing Syndrome
C. Diabetes Mellitus Type 1
D. Diabetes Insipidus
Correct Answer: D
Explanation: Diabetes Insipidus (DI) is characterized by a deficiency of ADH or a
decreased renal response to ADH, leading to the excretion of large amounts of dilute urine.
This excessive water loss results in hypernatremia and increased serum osmolality.
Patients typically experience intense thirst to compensate for the fluid loss.
2. In the diagnostic criteria for Diabetes Mellitus, which of the following glycated hemoglobin
(HbA1c) levels is considered indicative of the disease?
A. 5.2%
B. 6.5% or higher
,C. 6.0%
D. 4.8%
Correct Answer: B
Explanation: An HbA1c level of 6.5% or greater is one of the standard diagnostic criteria
for Diabetes Mellitus. This test measures the average blood glucose levels over the
preceding two to three months by assessing glucose attachment to hemoglobin. It provides
a more stable long-term indicator of glycemic control than a single fasting glucose
measurement.
3. Which pathophysiological mechanism best explains the development of Type 1 Diabetes
Mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Hypersecretion of glucagon by alpha cells
D. Excessive dietary glucose intake over time
Correct Answer: B
Explanation: Type 1 Diabetes Mellitus is primarily an autoimmune disorder where the
body’s immune system attacks and destroys insulin-producing beta cells in the Islets of
Langerhans. This leads to an absolute insulin deficiency, requiring lifelong exogenous
insulin replacement. The destruction is often mediated by T-cells and is frequently
associated with specific genetic markers.
, 4. A client exhibits exophthalmos, heat intolerance, and a fine tremor. Laboratory results
show a low TSH level and high free T4. Which condition is most likely?
A. Hashimoto Thyroiditis
B. Graves’ Disease
C. Myxedema
D. Hypoparathyroidism
Correct Answer: B
Explanation: Graves’ disease is an autoimmune form of hyperthyroidism where antibodies
stimulate the TSH receptor, causing excessive thyroid hormone production. Exophthalmos,
or bulging eyes, is a classic clinical sign specific to this condition due to inflammation in the
orbital tissues. The low TSH is a result of the negative feedback loop as the pituitary
attempts to downregulate thyroid activity.
5. Which of the following is a primary characteristic of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Hyponatremia due to water retention
B. Hypernatremia due to water loss
C. Excessive urine output
D. Severe dehydration
Correct Answer: A
Pathophysiology Q&A with Rationale | Portage
Learning
1. A patient presents with excessive thirst (polydipsia), a high serum sodium level, and a very
low urine specific gravity. Which of the following conditions is most likely responsible for
these findings?
A. SIADH
B. Cushing Syndrome
C. Diabetes Mellitus Type 1
D. Diabetes Insipidus
Correct Answer: D
Explanation: Diabetes Insipidus (DI) is characterized by a deficiency of ADH or a
decreased renal response to ADH, leading to the excretion of large amounts of dilute urine.
This excessive water loss results in hypernatremia and increased serum osmolality.
Patients typically experience intense thirst to compensate for the fluid loss.
2. In the diagnostic criteria for Diabetes Mellitus, which of the following glycated hemoglobin
(HbA1c) levels is considered indicative of the disease?
A. 5.2%
B. 6.5% or higher
,C. 6.0%
D. 4.8%
Correct Answer: B
Explanation: An HbA1c level of 6.5% or greater is one of the standard diagnostic criteria
for Diabetes Mellitus. This test measures the average blood glucose levels over the
preceding two to three months by assessing glucose attachment to hemoglobin. It provides
a more stable long-term indicator of glycemic control than a single fasting glucose
measurement.
3. Which pathophysiological mechanism best explains the development of Type 1 Diabetes
Mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Hypersecretion of glucagon by alpha cells
D. Excessive dietary glucose intake over time
Correct Answer: B
Explanation: Type 1 Diabetes Mellitus is primarily an autoimmune disorder where the
body’s immune system attacks and destroys insulin-producing beta cells in the Islets of
Langerhans. This leads to an absolute insulin deficiency, requiring lifelong exogenous
insulin replacement. The destruction is often mediated by T-cells and is frequently
associated with specific genetic markers.
, 4. A client exhibits exophthalmos, heat intolerance, and a fine tremor. Laboratory results
show a low TSH level and high free T4. Which condition is most likely?
A. Hashimoto Thyroiditis
B. Graves’ Disease
C. Myxedema
D. Hypoparathyroidism
Correct Answer: B
Explanation: Graves’ disease is an autoimmune form of hyperthyroidism where antibodies
stimulate the TSH receptor, causing excessive thyroid hormone production. Exophthalmos,
or bulging eyes, is a classic clinical sign specific to this condition due to inflammation in the
orbital tissues. The low TSH is a result of the negative feedback loop as the pituitary
attempts to downregulate thyroid activity.
5. Which of the following is a primary characteristic of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Hyponatremia due to water retention
B. Hypernatremia due to water loss
C. Excessive urine output
D. Severe dehydration
Correct Answer: A
